Unique Plan Description: Newborn Frenotomy
Plan Selection Display: Newborn Frenotomy
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-03-26 16:55:02
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-21 09:29:42
Available at all facilities: No

Newborn Frenotomy
Medications
	Tylenol pediatric oral syringe
		15 mg/kg, Syringe, Oral, By Mouth, Once, PRN, pain-moderate
			Comment: 30-60 minutes prior to procedure
		15 mg/kg, Syringe-Oral, By Mouth, Q6H, 4 Dose(s)/Time(s)
	Tylenol 325 mg/10.15 mL elixir
		15 mg/kg, Elixir, By Mouth, Once, PRN, pain-moderate
	Xylocaine-MPF 1% preservative-free injectable solution
		1 mL, Injection, SUBCUTANEOUS, Once, PRN, discomfort
Patient Care
	Frenotomy scheduled for:
		Date/Time T;N
	Obtain Consent/Permit for:
		T;N, Frenotomy
	Administer Oral Sucrose
		T;N, Once
			Comment: orally, by pacifier or by syringe. On call for Frenotomy.

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INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase